Scenario 1 - continued

Next, you decide to evaluate Jeremy’s intake … to provide more information about his macronutrient (energy, protein, carbohydrate, and fat) and micronutrient (vitamins and minerals) intake.

Jeremy’s parents describe Jeremy’s food pattern. He eats 3 meals and 2 or 3 snacks each day. The portion sizes that they describe are appropriate for a child Jeremy’s age. You ask them about the mealtime environment, and they tell you that he eats breakfast with his older brother, generally has lunch at school and a snack at afterschool day care. The family eats dinner together most nights, and Jeremy usually eats a snack before bed.

You are confident that the information they are providing is accurate and Jeremy’s growth pattern supports an adequate energy intake.

Jeremy’s mother says, “Oh, I almost forgot, Jeremy eats applesauce each morning, with breakfast. That is where we put his seizure medication.” You are glad she brought this up because you nearly forgot to ask about medications!

Back on track, you remember that there are some medication-nutrient interactions associated with some anti-seizure medications. Specifically, you are concerned about vitamin D and calcium and folic acid.

You decide that you need some specific information about the foods and amounts of foods that Jeremy usually eats in order to assess his vitamin D, calcium, and folic acid intake.

You ask Jeremy’s parents if the last few days were representative of what he eats. They tell you that they were on vacation, so his food pattern was unusual. They are comfortable with your suggestion to keep a food record now that Jeremy’s schedule is back to normal.